For pediatric heat stroke during transport, which cooling-related action is recommended?

• A. Move patient into the back of the rescue
• B. Decrease the air-conditioning temperature in the patient compartment
• C. BEGIN RAPID COOLING
• D. Administer Normal Saline bolus 20 ml/kg

Answer: (C)

Rapid cooling is the key action in pediatric heat stroke during transport. When heat stroke occurs, the child’s body overheats quickly and brain and organ damage can occur unless core temperature is reduced fast. Starting active cooling immediately directly tackles the dangerous hyperthermia and improves outcomes, more so than any attempt to change the vehicle’s environment or rely on fluids alone. Practical rapid cooling in transit includes applying ice packs or cold packs to the neck, groin, and armpits, and using cold water with a mist and a fan to promote evaporative cooling; if safe and feasible, cold water immersion can be used. These methods bring the core temperature down promptly while transport is arranged. Delaying cooling to adjust the cabin temperature or to initiate IV fluids without cooling does not address the urgent heat burden. IV fluids matter for perfusion and shock management, but they don’t substitute for the need to rapidly lower the body’s temperature.